CT SB00543

Requires all health insurance companies and related entities to cover inpatient substance abuse services for individuals diagnosed with substance use disorders until the patient's health condition is stabilized (effective January 1, 2018)

Applies to both individual and group health insurance policies providing coverage types specified in Connecticut General Statutes section 38a-469

Defines "stabilized" as a condition where no material deterioration in health is likely to result from transferring the insured from an inpatient facility

Permits insurers to conduct utilization review and seek recovery from insureds for non-medically necessary services, with recovery amounts capped at the Medicare reimbursement rate

Uses the same definition of "medically necessary" as provided in existing Connecticut General Statutes sections 38a-482a (individual policies) and 38a-513c (group policies)